Pennsylvania State Health and Life Insurance Exam
Automatic Premium Loan
Which of the following protects the insured from an unintentional policy lapse due to a nonpayment of premium?
Comprehensive
Combination plans are composed of two types of plan features: Basic and...
30 months
Employer health plans must provide primary coverage for individuals with end-stage renal disease before medicade becomes primary for how many months?
Hazards
Events or conditions that increase the chances of an insured loss occurring are referred to as
The licensee
If another governmental agency takes legal action against a licensee, whose responsibility is it to report the action?
Unfair claims methods and practices regulation
Should an insurance company deny a claim submitted by and insured without providing to that insured a prompt reason...
One-year term option
The dividend option in which the policy-owner uses dividends to purchase a term policy for one year is referred to as the
As of the application date
The full premium was submitted with the application for life insurance, and the policy was issued two weeks later as requested. When does the policy coverage become effective?
Implied
Which authority is not stated in an agents contract but is required for the agent to conduct business?
The aggregate amount of premiums due
Which of the following does not have to be disclosed in a long term care policy?
Life Paid-up at age 65
Which of the following is an example of a limited-pay life policy?
Sickness
Which of the following is an example of a peril covered in an accident and health insurance policy?
It remains the same no matter how many children are added to the policy
Which of the following is true about the premium on the children's rider in a life insurance policy?
Its nonrenewable
Which of the following is true regarding a term health policy?
Per capita
Which of the following methods to designate a beneficiary literally mean " By the Head"
Root Canal
Which of the following services would be covered by endodontics?
The mode of the premium payment
Which of the following will vary the length of the grace period in health insurance policies?
Controlled Business
Which of the following would not be considered an unfair and deceptive practice?
To guard against adverse selection and reduce cost
Why do group health providers usually require a certain amount of participation in the plan by eligible employees
The policy will terminate when the loan amount with interest equals or exceeds the cash value.
An Insured stops making payments on a loan taken from his cash value policy. What will most likely happen?
Variable
An insured receives a monthly summary for his life insurance policy. He notices that the cash value of the policy is significantly lower this month than it was last month. What type of policy does the insured have?
Respond to the consumer's complaint
Under the fair credit reporting act, if the consumer challenges the accuracy of the information contained in his or her report, the reporting agency must
The insurer can increase the policy premium on an individual basis
Which of the following is not a feature of a guaranteed renewable provision?
Iron
Which of the following is not a metal level of coverage offered under the patient protection and affordable care act?
Automatic Enrollment
Which of the following is not an enrollment period for medicare part a applicants?
it can be owned by individual employees
Which of the following is not true about a group annuity?
It would not occur in a deferred annuity
Which of the following is not true regarding the accumulation period of an annuity
Control Specialists costs
The gatekeeper of an HMO helps
Issuing sales material that are exaggerated
Which of the following best describes a misrepresentations?
Making derogatory oral statements about another's financial conditions
Which of the following best describes the unfair trade practice of defamation?
24 hours this reporting period. 24 the period following. 4 hours lost
A producer has successfully completed 52 hours of CE. How many CE will go towards this upcoming reporting period?
The insurer
An insurance advertisement exaggerates the benefits of an insurance policy, due to human error at the insurers advertising agency. Who will the department of Insurance hold accountable for the exaggeration?
5 years
In order to qualify for conversation from a group life policy that has been terminated to an individual policy of the same coverage, a person must have been insured under the group plan for how many years?
When the benefits received are equal or less than the employees percentage of the contribution
Under what condition are group disability income benefits received by an employee NOT taxable as income
Producer
Which of the following licensees is classified as a representative of the insurance company and not allowed to represent and insured or claimant?
Plan A
Which of the following must be present in all medicare supplement plans?
20%
Which of the following must the patient pay under Medicare Part B
It will pay double or triple the face amount.
Which of the following statements is TRUE concerning the accidental death rider?
the policy owner is entitled to policy loans
Which of the following statements is correct regarding a whole life policy?
A licensee is barred from charging a fee in addition to a commission to a person for the sale, solicitation or negotiation of a contract of insurance for commercial business
Which of the following statements is incorrect?
The commissioner
Which of the following entities must approve all continuing education courses in the state?
Antibiotics
Which of the following hospice expenses would not be covered in a cost-containment setting?
Policy Owner
Which of the following individuals must have insurable interest in the insured?
Forwarding premiums to the insurer
Which of the following is an example of an agent's fiduciary responsibilities?
Be responsible for at least 25% of total commissions collected by the office that he or she manages
A person applying for a manager or exclusive general agent license must meet all of the following criteria EXCEPT
Viatical settlement purchaser
A person who gives money as consideration for a life insurance policy or intrest in the death benefits of a life insurance policy is called a
Dread Disease Policy
A policy which covers medical costs related to a specific condition is called a
The cost of coverage is based on the ratio of men and women in this group
Which of the following statements about group life is correct?
Express Authority
The authority granted to an agent through the agents contract is referred to as
Perils
The clause of loss insured against in an insurance policy are known as
The employer is the policy holder
Which of the following statements concerning group health insurance is correct?
Target Premium
Which of the following would help prevent a universal life policy from lapsing?
Joint Life
A couple receives a set amount of income from their annuity. When the wife dies the husband no longer receives annuity payments. What type of annuity did the couple buy?
The surrender value should equal to 100% of the premium paid, minus any prior withdrawals and surrender charges
A deferred annuity is surrendered by prior to annuitization. Which of the following best describes the nonforfeiture value of the annuity?
Separate Accounts
A domestic insurer issuing variable contracts must establish one or more
a summer camp
A group blanket health policy is best suited for which of the following?
income
A typical accidental death & dismemberment policy covers all of the following losses except
Copy of the original application
According to the entire contract provision, what document must be made part of the insurance policy?
The consumer directs the licensee not to disclose the consumers nonpublic personal financial information to a third party
According to the privacy of consumer financial information regulation, if a consumer decides to opt out, this means
Fair Credit reporting act
An applicant is denied insurance because of information found on a consumer reports...
It is used to lower premiums
An insurer invests the money it receives from premiums paid by the insureds. Which of the following is true regarding the interest earned on these investments?
Predicted needs of the family after the insured's death
Based on Human Life Value Approach, which of the following is not used to calculate an individual's value of life?
Yes and they may use any preferred physician, even if not part of the HMO
Can an individual who belongs to a POS plan use an out-of-network physician?
20 days
Following hospitalization because of an accident, Bill was confined in a skilled nursing facility. Medicare will pay full benefits in this facility for how many days?
Coercion
Forcing a client to buy insurance from a particular lender as a condition of granting a loan is defined as
Selection, classification, and ration of risks.
Health insurance underwriting is best defined as
They are tax deductible
How are employer contributions to health reimbursement accounts treated in regards to taxation?
Must appear as a separate paragraph and be clearly labeled
In a long-term care policy, pre-existing condition limitations
90 Days
Most policies will pay the accident death benefits as long as the death is caused by the accident and occurs within
15 Calendar days
Once a viatical contract has been established, how long does the Viator have to rescind the contract?
Reciprocity
Paul is a producer in OH and wants to become a producer in PA. The commissioner will waive certain certain examination requirements, provided that OH would waive these same requirements. What is the term to describe this phenomenon
24 Credit Hours
Prior to license renewal, all insurance producers must successfully complete a minimum of
Age 65 who are not retired
The Omnibus Budget Reconciliation Act of 1990 requires that large group health plans must provide primary coverage for disabled individuals under...
Cancellation
The act of voluntarily giving up insurance by the insured is called
Entire Contract Clause
The provision in a health insurance policy that ensures that the insurer cannot refer to any document that is not contained in the contract is the
an individual who was previously covered by group health insurance for 6 months is eligible
Under HIPAA, which of the following is incorrect regarding eligibility requirements for conversion to an individual policy?
Immediately
A health Insurance policy lapses but is reinstated within an acceptable time frame. How soon from the reinstatement date will coverage for accidents become effective?
They are exempt as long as they are on active duty, and for 6 months afterwards
A licensee serving in the military is unable to fulfill her continuing education requirement. What would the licensee have to do to renew the license?
Prior to the time of application
A long-term care shoppers guide must be presented at what point
Sudden and Unforeseen
A person steps off a streetcar and trips and breaks his ankle. This type of injury can be described as
Having all employees complete continuing education courses once every 2 years
All of the following are licensing requirements for a business entity, EXCEPT
MIB reports are based upon information supplied by doctors and hospitals
All of the following are true regarding the medical Information Bureau (MIB) Except
Suggesting negotiations in settling the claim
All of the following are unfair claims settlement practices except
dividend amounts are guaranteed in the policy
All of the following statements concerning dividends are true except
Consideration Clause
An Applicant for an individual Health policy failed to complete the application properly. Her stay at the hospital was not covered by insurance because she has not met the conditions specified in the...
Concealment
An Applicant knowingly fails to communicate information that would help an underwriter make a sound decision regarding coverage. This is an example of
Refund the premiums paid
An Insured committed suicide one year after his life insurance policy was issued. The insurer will...
5 days
If a consumer requests additional information concerning an investigative consumer report, how long does the insurer or reporting agency have to comply?
The surrender charge is a percentage of the cash value and decreases over time
If a deferred annuity is surrendered prematurely, a surrender charge is imposed. How is the surrender charge determined?
All providers will have the same coverage
In reference to the standard medicare supplement benefits plans, what does the term standard mean?
A mutual insurer
Insurance companies may be classified according to the legal form of their ownership. The type of company organized to return any surplus money to their policyholders is
Producers report
The insurance company underwriter could find information concerning the personal activities and character of an applicant from which of the following reports?
2 years
The relation of earnings to insurance provision allows the insurance company to limit the insured's benefits to his/her average income over what period of time?
Insuring Clause
The section of the health policy that states the causes of eligible loss under which an insured is assumed to be disabled is the
6 credits
To attain currently insured status under social security, a worker must have earned at least how many credits during the last 13 quarters?
For 20 years or until death, whichever occurs first.
Under a 20-pay whole life policy, in order for the policy to pay the death benefit to the beneficiary, the premiums must be paid
are made by the business and are not tax deductible
Under a key person disability income policy, premium payments
The same face amount as in the whole life policy
Under an extended term nonforfeiture option, the policy cash value is converted to
Monthly
Under an individual disability policy, the MINIMUM schedule of time in which claim payments must me made to an insured is
Ownership
What is the major difference between a stock company and mutual company
To cover the expenses of retraining the insured to return to work.
What is the purpose of the rehabilitation benefit in disability insurance?
National Do not call registry
What was created to keep telemarketers from calling consumers who do not wish to be contacted?
180 days
When a producer died, his surviving spouse needed to maintain the insurance agency until it could be sold, without testing she could qualify for a temporary license for a max period of
When the premium is paid at the time of application.
When is the insurability conditional receipt given?
Cease and Desist
When the commissioner suspects a person is violating an insurance law or other regulation...
8am until 9pm
According to the telemarketing sales rules, what are the permissible calling hours for telemarketing calls?
Any children born to them after the inception of the contract
Bob purchased a policy to provide coverage on himself, his wife Linda, and their two children, John and Kristen. All of the would need to prove insurability except.
Assets
In a replacement situation, all of the following must be consider except
Premiums are not tax deductible as business expenses
Which of the following is correct concerning the taxation of premiums in a key-person life insurance policy?
Annuity Certain
Your client plans to retire at age 50. He would like to purchase an annuity that would provide income from the tie he retires to the age when social securities and other pension funds become available.
The owner must be the party to receive benefits
All of the following are true of an annuity owner except
Death Benefit
Which component increases in the increasing term insurance?
Indemnity
Which insurance principle states that if a policy allows for greater compensation than the financial loss incurred, the insured may only receive benefits for the amount lost?
Extended Term
Which nonforfeiture option has the highest amount of insurance protection?
Payor benefits
Which of the following allows the insurer to relieve a minor insured from premium payments if the minors parents have died or become disabled
Commissioner
Which of the following authorities is authorized to issue a temporary insurance producers license?
A person who negotiates insurance contracts
Which of the following persons is required to hold a producer license?
Medicare
Which of the following programs is made up of 4 parts, where the first part is paid for by FICA, and the second part is financed by premiums and payroll taxes?
Bail-out
Which of the following provisions in annuity contracts allow the owner to te surrender the annuity if interests rates drop to a specified level.
Within 30 days
How soon after the due date should the insurer pay the agent appointment fees?
Jumping Juvenile Policy
If a life insurance policy increases significantly in face amount when the insured reaches a specified age, what type of policy is this?
Whether and insurable interest exists between the individuals.
If an applicant for a life insurance policy and person to be insured by the policy are two different people, the underwriter would be concerned about
Require evidence of insurability
If an employee wants to enter the group outside of the open enrollment period, to reduce adverse selection, the insurer may
30 Days
If an insurer terminates a producer, the insurer must notify the commissioner within how many days?
Calls based from outside the United States
Which of the following would not be considered an expectation to the national do not call list?
A Contributory Plan
Jason is insured under his employers group health insurance. He splits the cost of the premiums with his employer. This is an example of
A level annual premium for the life of the insured
A straight Life policy has what type of premium?
Must be informed of the source of the report
Under the Fair Credit Reporting Act, individuals rejected for insurance due to information contained in a consumer report
Disability Buy-Sell
Which agreement specifies how a business will transfer hands when one of the owners dies or becomes disabled?
The period of time during which accumulated money is converted into income payments
Which of the following best describes what the annuity period is?
It provides income the beneficiary can't outlive
Which of the following is true regarding a single life settlement option?
it can protect the policy proceeds from creditors of the beneficiary
Which of the following is true regarding the spendthrift clause in life insurance policies?